Veterinary medicines – really a rip-off?

Price isn't everything

Earlier this week, the BBC’s “Watchdog” ran a programme on the costs of veterinary medicines. This is a perennial favourite (some readers may remember the Marsh / Competition Commission reports from the early 2000s where they concluded that there was a “complex monopoly” on veterinary medicines). The conclusion many viewers drew from the way the programme was presented was that vets were ripping off their customers by over-charging for medicines. I’m in the unusual situation of having worked in veterinary practice, but also having run a small online dispensary, and I think there are several issues we need to look at here. There definitely are significant differences in pricing strategies between different veterinary practices and companies, and it’s worth exploring why this is.

 

What did the programme find?

That (shock, horror!) it’s cheaper to buy many medications online, rather than through the vets. (Just out of interest, I wonder if Watchdog is next proposing to do a shock expose of how high street retailers are ripping customers off because you can buy most things more cheaply on Amazon… but probably not.)

 

Are vets ripping off animal owners?

To be completely honest, a few probably are. However, this is the exception not the rule – veterinary practices are very, very expensive to run, and ultimately there’s no NHS for pets. Apart from anything else, all veterinary practices are required by law to have a large notice displayed informing clients that they can always request a written prescription to buy any medications they need elsewhere. I don’t know of any practices that don’t have these posters up (sometimes very large and prominent) – unfortunately, for many clients they become the “background wallpaper” of the practice.

 

Why do vets charge more?

As I’ve said above, practices are expensive to run. The premises often attract premium business rates; the equipment we need to work is expensive and needs regular servicing, maintenance and often replacement; and there are a lot of regulations regarding health and safety, radiation protection, medicine storage and so on that, while necessary, are also expensive to comply with. Then of course there are staff costs – contrary to popular opinion, vets are not especially well paid as professionals; surveys suggest that most vets start at about £30,000 (which is a good wage, although I’ve never worked in a practice that paid a new graduate that much!), but salary for employed vets (which is the vast majority of us) averages about £43000 – good money, but when compared to the average salary of £115000 for doctors, not especially well paid. Veterinary nurses, meanwhile, are much worse off, with most of these highly trained professionals earning less than £20000. However, there are additional costs here to bear in mind as well – vets and nurses are obliged to continue in education (a minimum of 35 hours a year for vets, 15 for nurses), and this is also expensive, as is the legal obligation to either be open, or pay someone else to be open, 24/7 for emergencies.

Now, the funding for all this doesn’t come from the government, or in most cases charity. It comes from the fees animal owners pay, and historically, vets have used markups on medicines (usually a 1-200% markup, which is a LOT less than most high street chains!) to subsidise the business, keeping professional fees (consult charges etc) lower than they otherwise would be. As vet Robin Hargreaves said on the programme, ‘I could push people into getting online prescriptions but then I would have to put my fees up’. So, would you rather pay high medicine costs IF your pet needs the medication, or higher consult charges every time you see the vet? It’s an interesting question, isn’t it?!

 

Compared to this, an online pharmacy or dispensary has much, much lower overheads – they can operate from a warehouse (paying lower business rates!) and don’t have the same equipment costs, don’t need to provide an emergency service around the clock, and just need one dispensing vet or pharmacist on-site, everyone else can be low-paid workers (potentially on minimum-wage, zero-hours contracts if they want to save money). And this is assuming that you’re buying from a reputable legal business, not a warehouse in the far east selling cheap imitation products (the nightmare scenario for vets in practice, because it’s the vet who has to pick up the pieces when the animal doesn’t respond or is poisoned by the “medicine”).

 

The second complication is the cost of the drugs themselves. Most practices, even if they’re part of a larger corporate entity, are only buying relatively small quantities of drugs at a time – because the medicines have a limited shelf-life and they don’t want to risk being left with lots of expensive out-of-date drugs; plus they probably don’t have the cashflow to be able to purchase £100,000 worth of flea treatments in one go. However, as with most things, the best discounts come with bulk buying – and in many cases, the big online companies can buy the drugs in from the manufacturers a LOT cheaper than practices can. In fact, in some cases, medicines are being sold by the online pharmacies (including VAT) cheaper than vets in practice can buy them. (Sadly, it is illegal for vets to source drugs from another retailer – we’re only allowed to buy from wholesalers).

 

Which is better?

‘Price isn’t everything and you can’t beat the professional service that most vets provide’ (Judge Rinder). When you buy from the vets, you are getting an end-to-end service – as Robin pointed out, ‘There’s more to the service when I prescribe something for a client two weeks later they say I’m not quite sure whether its working, they are going to ring me and I will spend time supporting the product’. The online businesses can’t do that – not their legal obligation, and it doesn’t really fit into their business model.

On the other hand, they genuinely are cheaper – I buy most medicines for my own animals online – as long as you remember to factor in the prescription charge from the practice. Buying a prescription-only medicine without a prescription is in fact illegal, which does close the gap a little.

 

Is there a way forward?

Personally, I think vets usually charge too much for medicines, and too little for professional fees – we are constantly underselling ourselves. However, any change to pricing models (even to keep the same overall income for the practice) risks hitting the poorest owners the hardest. If you want to buy online, that’s absolutely fine – I would actually quite like to see a situation where vets move away from selling drugs, except those for immediate or emergency use, and make up the money instead from the prescription fee (prescribing is actually one of the most complicated and risky parts of a vet’s daily life). That way the pricing is at least transparent, and of course it’s also more similar to how our medical colleagues work – it also removes any bias in terms of what drugs we prescribe.

From the perspective of the animal owner, I have no problem with using online retailers. HOWEVER… make sure it’s a reputable company! The VMD (the UK veterinary medicines regulator) has a list of accredited retailers, those who abide by a code of conduct that is set well above the legal requirements. And do NOT buy from overseas, no matter how tempting the prices seem – it’s illegal, the drugs may not be what you expect, and may even be dangerous.

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63 thoughts on “Veterinary medicines – really a rip-off?

  1. 1-200% markup? I would not have minded that today. My vet dispensed 14 x 15mg mirtazipine as an appetite stimulant today. Over £33!!! Bearing a pack of 28 of the same drug from the chemist was £7.20. That’s almost 10x the price of the chemist! That’s a 1000% mark up! I’m disgusted and feel taken advantage of at a distressing time.

    1. The problem is that mirtazipine is a human medication, without a veterinary license, prescribed on the Cascade. When vets buy in licensed animal medications, there are a variety of discounts available for bulk buying, loyalty, etc. Likewise, human pharmacies get the same discounts. However, a vet will not get them on a human product in most cases – meaning they have to pay the manufacturer the full price, not the negotiated discounts that the pharmacy get. In some cases, these discounts can reduce the price paid by the pharmacy by 80 or 90% – hence the price difference.

      1. While I accept some of your arguments there are still vets who profiteer from medicine sales. Yesterday I was charged £147.00 for the vet to see my dog who had a torn dew claw. I was further charged £42.00 for a simple bandage, £46.75 for 10ml of metacalm (£3.60 online), £19.50 for a recovery collar (£1.99 online). I was then charged £25.00 for the receptionist to post my insurance form (which I had filled in) to the company. Ultimately the bill came to £336.75 for bandaging a ( painful) hangnail.

      2. I took my cat to vets as he he had a scratch on his eye due to fight or branch they put dye solution to look and it was the size of a pinhead if not smaller and looked as if it was healing but a week later he had a film growing over his pupil took bk and was prescribe eye drops and eye cream it was a free consultation as in my health check I pay for them but was charged 108pounds for the stuff

        1. Some of the more powerful eye drops are very expensive, especially if a combination of medicines is needed. This is a situation where you need the drops ASAP rather than waiting to shop around!

  2. This is a feeble excuse! How long does it take for the vet to say ‘hey you can get these much cheaper elsewhere’. They claim to be animal lovers but these extortionate, usually disguised charges are harming the animals in the long run.

      1. Could you tell me where all these vets are that are telling their clients they can get cheaper meds elsewhere? I’m sure we would all like to find them.
        I’ve never met one in practice that would tell you that and I’ve been working across farming, equestrian and dogs for many years and met many vets from different practices and specialities in veterinary medicine.
        Exactly how are these so called regulations being implemented by the RVC? I would take a guess it’s self regulation.

        1. The RVC is London Vet School – they have nothing to do with this? I think you might want to check your references…

          1. Accidentally put RVC, which I think most people would of understood especially a vet. Thanks for pointing that out though, I meant the Royal College of Standards RC.
            So who is implementing those regulations and really making sure they are being adhered to?
            I’ve just had a dog spayed and a dental done and no itemisation other than the fee for the spay and the fee for the dental and I had to ask for it. Always have to ask for a prescription as well.

          2. The RCVS is the Royal College of Veterinary Surgeons, and the regulator for veterinary surgeons and veterinary nurses. They have no powers in law to regulate the practices unfortunately – although there are moves to ask the government for a legislative review to give them those rights, there is also concern about regulatory overreach among some in the profession. Personally, I’m all in favour of the RCVS regulating practices as well as individual vets’ clinical standards!
            My advice would be to raise this issue with your practice and explain that you don’t understand how they are following the RCVS guidance. It may be that they are using the alternative methods (e.g. incorporation in client business agreements) to meet their requirements, that you weren’t aware of. Alternatively, it may be an oversight which they will be easily able to correct.
            The RCVS has no right of inspection of private practices except when linked to the PSS, and can only legally investigate if a complaint is received.

          3. Sorry, I meant Royal College of Standards RCS. Could you answer the question, How are these regulations being implemented?

  3. At our Vets you’d struggle to spot the colour of the walls let alone find a poster saying that we are not obligated to have their prescription and could get it else were because it is 4 walls of adverts promoting every treatment a cat, dog or horse (etc) could ever use in it’s lifetime.

    I have no problem with a company making a profit but something that really annoys me is when you take a dog to the vet with a runny tummy (the poops) and, except for the caring and respectful assessment of the dog, the advice is pretty much what was read online with the addition of a week’s worth of expensive meds when all the dog needed was 24 hours off food and being put on a bland diet for a few days…

    Many ailments a dog (or cat etc) has are like we get and will sort themselves out in a few days but we always seem to end up being prescribed some very expensive tablets for a week even though the pet got better in a couple of days as nature intended.

    We once took one of our dogs to the vet with a cough (there was some kennel cough in the area at the time) and he was ‘examined’ outside on the path in about 1 minute, prescribed a week’s worth of cough tablets and we were sixty five quid lighter. That felt like a swift kick where it hurts.

    So fair enough; profit is a necessary evil of business but hundreds of percent profit on meds, prescribing a week’s worth of meds when a couple of days is all the animal needs (if any) is pushing it a bit.

  4. The response by vets here is wholly inappropriate.

    I am a former managing director of a pharmaceutical wholesalers. There is huge competition for generic drugs and as wholesalers compete for business they will supply any licensed vet or pharma toy at the same price. Even assuming a dispensing fee and 100% mark up the prices vets charge cannot be justified. For example take Tramadol liquid which my dogs vet prescribes. Two bottles from the vet £32.00. Exactly the same product from a retail pharmacy £11.00 including a dispensing fee and mark up. My vet charges £9.00 for a written prescription. This takes the cost to £20.00. That’s still £10.00 cheaper. Now my vet is threatening to change the prescription to a brand available from a veterinary wholesaler that isn’t accessible to a retail pharmacy. This stinks of a cartel!

    1. Sadly, the legal situation the veterinary profession works under is slightly different. Under the Veterinary Medicines Regulations it is illegal for a vet to prescribe a human generic product if there is a licensed veterinary option – unless there are clinical (not financial) reasons to do so. This is a system called the Cascade, and as a veterinary licensed tramadol has just become available, it’s why the vet want to change what they’re prescribing.
      Regarding the cost of human medicines, I’m very impressed that your former company was passing on bulk, wholesaler and manufacturer’s rebates to veterinary practices on human products – I used to manage a veterinary online dispensary, and we never found anyone who was willing to do that! I wish I’d known about that company then…
      Unfortunately, with every wholesaler I’ve ever worked with, the discounts and rebates that the human retail pharmacies trade on just never arrive, so we have to charge out at list plus markup for human products, not net net plus markup. In fact, some even charge a premium (usually about 2.5%) on top of list price to supply a human product (especially a controlled drug) to a veterinary premises.

        1. And in 17 years things have changed a lot… the balance sheets of most veterinary practices are far less rosy than they were then.

  5. Today I asked for a 7 day prescription of Traileve and VetMedin and I was told would be ready in 24 hours but as I was out (my own fault) I could ring by the end of the day to check if they had any. I was told they hadn’t but how many tablets would I need to tie me over, I said it is only the Vetmedin and my dog would need 3 (1 1/2 tonight and tomorrow morning) I pay over the phone and my mum collects it. For 3 tablets they charged me £11.45 approx £3.81 per tablet. I understand they helped me out and I am grateful. I accept a mark up and I will be sourcing them online for the future. What I don’t understand is how theyhave charged it. The receipt breaks down 3 Vet Medin at £9.54 and £1.91 per tablet. If there is a mark up due to the lateness and quick turnover but surely they should price the tablet as it’s cost and the extra as an additional charge? I go tomorrow to collect the other 18 tablets. Will I therefore be charged £68.70 when I brought a month (90 tablets) I paid £163.87. Aside from charges for the inconvenience and it being out of a box what I am interested in is whether although more expensive do drugs at a vet practice have a set price or how are drug prices calculated and charged. I am worrying because I have to go and collect the 6 days tablets tomorrow and I’m scared paying another £68.70 for the Vetmedin alone when I need to buy a month supply which costs me £88 online. I know it’s my own fault for it lapsing but I could just do with advice

    1. Every practice will charge slightly differently; however, in general, there’s a fixed dispensing charge (however much you’re collecting) plus a price per tablet. Even if you’re only getting a handful of tablets, the dispensing fee will be the same. If in doubt though, ask how the prices were worked out! The practice should give you a fully itemised bill if you request it.

  6. Of course one would expect the vets to make some profit, but I cannot see that a 73% mark up on an Apoquel tablet is appropriate. And I just don’t believe that the consultation charges aren’t already quite costly enough – the argument just doesn’t wash. And £16 for writing a prescription (for a three month supply) isn’t exactly cheap either.

    1. Remember, that 73% markup isn’t profit for the practice – it’s paying the bills and the salary costs of the staff who work there. If they reduced the markup, they’d have to put the price up on the consults (which as you say would also be unpopular). Good quality veterinary care is not cheap, unfortunately – take a look at my colleague Pete’s blog here about where the money goes.

  7. My vets have always been open about their obligations to the practice and their suppliers and very happy for you to source medicines elsewhere. I have occasionally taken advantage of this, but for emergencies I find vets (and their supplies) are worth more than every penny. I see some very unbiased and honest answers here from the vet and it might do to remember that they are human, have trained very hard to deal with some very tricky situations involving much loved pets and can be with you almost impossibly quickly in an emergency. Keep your fingers crossed you don’t need them to be!

  8. I understand and respect that good quality care isn’t cheap. But I don’t agree with astronomical mark ups. I have two cats both of which are anxious at vet visits. We had to get specific testing done and it was recommended for them to be on Gabapentin prior to the visit. So one tablet the night before and one the morning of the appointment, my question is on the vets own website it states the same exact 100mg pill is 0.25/pill so a total of 2 pills per cat would be $1 I was charged 18×2 $36 for 4 pills. Mind u I wasn’t given the medication until 2 days prior and so I would not have time to order the medication fast forward upon testing they were required for a 2nd visit and after that my one was required to undergo dental work. So I spent a total of $90.00usd on 12 pills when from the website that belongs to them I could have ordered these pills for 3.00 total with no shipping and handling. My question is this normal practice and are their no standards to regulations as to how much they can charge per pill?

    1. Unfortunately, the legal situation in the US is rather different from in the UK, which we’re most familiar with. I’m afraid I can’t help you as a result – although your vet should be able to explain their pricing structure if you ask them.

      1. Thank you for your reply. I’m not having luck as I did call to inquire and was advised that the practice manager would call me back it’s been 3 days. I will call again as I can not locate anything about regulations on line so I didn’t think it hurt to ask. Thank you again.

        1. I’m sorry we can’t be more helpful! Unfortunately, the legal system around veterinary medicines is very different in the States compared to here in the U.K. and I really don’t want to give you incorrect advice.

  9. I purchased some pain relief today. The bottle is only half full so I would say it’s costs £1.50 online. They charged me £15. 1000% mark up. I’m disgusted. They are trained to trick your mind. £15. That’s not a lot. I’m happy to pay that lol. Then you realise you have been taken for a ride.

    1. Does that £15 include the prescription charge as well? Most of the cost is probably paying for the expertise of the veterinary surgeon to prescribe the appropriate medication. Remember, you have a legal right to obtain a written prescription and purchase elsewhere.

  10. Is £460 for 30 days supply of 500mg levetiracetam even close to reasonable from a vet? Another vet charged £80….

    1. Unfortunately, it’s illegal for any vet (including me) to ask what price another vet charges, as this would be in breach of Competition Commission rulings. So I’m afraid I can’t comment on your exact question!
      I can say that there are a couple of possible causes for the difference. Firstly, different vets use different suppliers, who may change differently; and secondly, different practices have different charging policies. One may charge more for meds and less for consults, another the other way round. And finally, if there is a shortage of a medication, the price often goes up – and right now we’re seeing a lot of meds being short of stock.

  11. This is only indirectly about drug prices. We at one time carried out work for a large multi outlet vets , when speaking to one of the owners he told as that because of insurance for pets they had put up prices by 35%. I agree that vets them selves are not over paid but often practice owners make small fotunes in some cases. ( my great grand father was a vet)

  12. Bravecto at vets 37.64 Milbermax 22.44. Online Bravecto 16.51 Milbermax 3.12. Prescription charge £28 for each item. I was offered a Health Care plan @ £14.60 per month. That’s £350 p.a for both cats. I am a pensioner getting less than £10000 p.a. Do you find that fair?

    1. Take a look at the economics of running a practice, the staff wages, and the business rates the practice has to pay compared to the costs of an online retailer – is that fair?

    1. Here’s the problem with that. If you force the prices so low that the practice can’t cover their costs, the practice goes out of business and there’s no vets to see to your animals.

      1. But please remember how much you buy your medications in for and how much you charge your clients. It should not be a profit making business, the same way the NHS is not profit making business for human health. I was charged £77.92 for 40 pred tablets and 5 sachets of powder to reduce mucus production. The pred tablets can be bought for as little as £0.08 per tablet and the sachets £2.50 per tablet. It would have cost £28.50 so a difference of £49.42

        1. But it is – because someone has to pay the vet, and the nurses, and the Government won’t do it, and the charities can’t afford it.

  13. I use to work as a vet nurse and know how low vets buy in medication and how much they can charge. I recently was charged £77.92 for 40 pred steroid tablets, and 5 sachets of a mucus reduction powder. Preds are about £0.08 pence per tablet, and the sachets sell at £2.50. I was told it would cost £180 for an endoscopy up her nose, which I was pleased with, when I went to pay the bill was £407, apparently they did blood tests, xray and a swab… i have not been told any results just that nothing showed up, yet my dog is worse and now having more exploratory which is money I do not have. My insurance has already paid out towards the £407, as the vet we were referred to as part of the group Medivet sent off the forms, but sent her back to our vets saying they could find nothing.

  14. I so agree with you. I think also that they should be monitored regularly especially on how some staff are treated.

  15. My heart bleeds for vets who think they may be on insufficient salaries. £37 for a 4 minute check (post treatment, so it should have been free really). That works out a at £555 per hour (yes I know there are overheads and a lot of consultations last longer than 4 mins). Multiply that by the number of vets in the practise. And all the vet did was weigh my cat and give him a good feel. Highly skilled.

    1. Roughly 20-40% of the consult fee is used to pay salaries – not just of that vet but the other vets, the nurses and the support staff too. And the time budget for that post treatment check is probably 10-15 minutes – great if you don’t need it, but if you had, it would have been the same price. Oh, and that “good feel” is a skill called palpation, which takes about 7-8 years training to be proficient at.

  16. Once your animal is on medication for life why does it cost me £28 for the prescription each time to buy the medication online, the vet took 20sec to write the prescription, something needs to be done very soon because owners are handing their dogs in to rehoming centres because they can’t afford to pay these extortionate prices, £600 for dog to have 2 teeth extracted, Human dentistry is no where near that price

    1. Most humans don’t bite the dentist… Every dog or cat dental requires a general anaesthetic, which is where much of that fee goes.
      Regarding the prescription charge – because the vet is liable for anything that goes wrong as a result of that prescription. They, or their practice, pay the professional insurance costs (which are a legal obligation), that and the training and skillset required to select the correct medication and make sure it’s still appropriate are what you’re paying for.

      1. Yes dentist can get bitten by patients, they also can get punched, stabbed etc by their patients. Unfortunately, not many vets either give itemise bills, as was found in the investigation into them and their relationship with pharma companies in 2009 and not much has changed since then
        https://webarchive.nationalarchives.gov.uk/20120120001958/http://www.competition-commission.org.uk//rep_pub/reports/2003/478vetmeds.htm
        So how would this person know what they were charged for the anaesthetic?

          1. Yes, I know they are a requirement and should be given without having to be asked for, but the reality is some don’t give a bill, unless asked and if you do get a bill, it is not itemised to the extent it should be. I recently, had a dog operated on and the procedure was priced as a whole. The anaesthetic was not priced separately, as it should be.

  17. I wrote a blog a while ago https://www.thepoundlanespaniel.com/whats-going-on-at-poundlane-2010-to-2020/october-24th-2016, about vets over vaccinating puppies and found some interesting pieces. The first was https://webarchive.nationalarchives.gov.uk/20120120001958/http://www.competition-commission.org.uk//rep_pub/reports/2003/478vetmeds.htm and it covers the very cosy relationship between vets and pharma. Lets take a look at what they found out:
    ‘The monopoly situations

    We found one scale, and three complex, monopoly situations within the meaning of the Fair Trading Act 1973 (FTA):
    – National Veterinary Services Ltd (NVS), a wholly-owned subsidiary of Dechra Pharmaceuticals PLC (Dechra), supplies more than one-quarter of all POMs at the wholesale level and so meets the definition of a scale monopoly.

    – The first complex monopoly situation involves veterinary surgeons engaged in one or more of the following conducts:

    (a) failure to inform animal owners that they can ask for prescriptions, or discouraging requests for prescriptions, or declining to provide prescriptions on request;

    (b) failure to inform clients of the price of POMs prior to dispensing them, or to provide itemized bills; and

    (c) pricing of POMs which does not reflect their cost of supply, including:

    (i) mark-ups on manufacturers’ list prices that take no account of the discounts and rebates they receive from wholesalers and manufacturers, or do not reflect variations in those discounts and rebates; and

    (ii) pricing POMs to subsidize, to a greater or lesser extent, professional fees.

    – The second complex monopoly situation arises from the failure of eight manufacturers (Fort Dodge Animal Health Ltd (Fort Dodge), Intervet UK Ltd (Intervet), Merial Animal Health Ltd (Merial), Novartis Animal Health UK Ltd (Novartis), Pfizer Ltd (Pfizer), Pharmacia Ltd (Pharmacia Animal Health) (Pharmacia), Schering-Plough Ltd (Schering-Plough Animal Health (UK)) (Schering-Plough) and Virbac Ltd (Virbac)) to enable pharmacies to obtain supplies of POMs on terms which would enable them to compete with veterinary surgeons.

    – The third complex monopoly situation arises from the failure of all the veterinary wholesalers to take reasonable steps to market to pharmacies and supply them with POMs, so that they can compete with veterinary surgeons.

    We found these conducts, which have the effect of preventing, restricting or distorting competition, to be interconnected in ways that are important for a proper understanding of the lack of competition in this market:

    – First, through interconnections of effect, in that conducts at the different levels combine to raise barriers to entry and expansion by pharmacies.
    – Second, through interconnections of relationship: the manufacturers, wholesalers and veterinary surgeons each maintain direct relationships with the others.

    – Third, through interconnections of justification, in that certain conducts at one level in the supply chain provide a rationale for those at other levels to maintain their conducts.

    – Fourth, through interconnections of benefit, in that each of those engaged in the conducts benefits from the conducts of the others through their combined effects.

    – Fifth, through interconnections of dependence, in that certain conducts at one level of the supply chain depend upon conducts at others.
    Markets, competition and prices

    At the manufacturer level we identified the UK as the relevant geographic markets for the supply of POMs and identified 30 separate product markets under five broad headings. Of the five veterinary wholesalers in the UK, three operate in most regions of Great Britain; one operates in Scotland, Wales and northern England; and one, only in Northern Ireland. Competition between veterinary practices is local.

    An examination of all three levels in the supply chain led us to conclude that competition in the supply of POMs is weakest at the retail level and that, as a result of the conducts listed in paragraph 1.3, pharmacies provide only minimal competition for veterinary surgeons.

    Comparison of the UK prices of some commonly-used POMs with those in other European countries showed that, for the veterinary medicines studied:

    (a) Most best-selling POMs in the UK are substantially more expensive, ex-manufacturer, than in all the European countries in our study.

    (b) The difference in price between the UK and other European countries is greater for POMs, ex manufacturer, than for other veterinary medicines, and countries where pharmacies play a larger role in their supply have the lowest ex-manufacturer prices.

    (c) Retail prices for POMs (excluding VAT) are never lower and are generally substantially higher in Great Britain.

    (d) For those POMs for which it was possible to make a comparison of retail prices after adjusting for differences in ex-manufacturer prices, prices in Great Britain are still higher in the majority of cases.’

    I personally have yet to see any changes that have been suggested in that investigation. I have yet to see any posters in any vets about getting prescription medicines or in a consult be advised about using prescription as cheaper to source for dogs on long term prescriptions. The dogs I have had on long term heart medication, I would have had to have them put down earlier, the medication is so expensive via the vets. 200% markup on how much I pay for them online.
    My independent vet got taken over by IVC Evidensia Ltd last year. Apparently just a little old Bristol veterinary practice. That’s what I was told, but they are not. They own 14,000 clinics in 11 European countries. Parent organisation is IVC Evidensia Medco Ltd. Not sure what they are, says some sort of holding company and as you know a holding company typically exists for the sole purpose of controlling other companies to make shed loads of money for most often those who don’t give a s__t about anything other than how much money they can hoard away. I have been told they paper chase back to being owned by a big Pharma company. I have found Nestle Purina own shares in them. I smell monopolisation by the back door. I have rang them asking if they are owned by a pharma company and I’m waiting for an answer. Since they took over my vet’s. The out of hours has gone from £80 to £150 in less than 12 months and prescriptions are now £16 from £12 less than 6 months ago. Someone I know who is in a farmers buying group, got told by one of the farmers in the group that their vet’s now (owned by this company) are charging £50 for a prescription.
    Nothing has changed since the 2001 . In fact, things have carried on as before, they are just making the tracks harder to follow.
    Vets sign up “to safeguard the health and welfare of animals committed to veterinary care” Vets turning a blind eye to pharma companies monopolising veterinary care and charging what they like, I would argue is not safeguarding the health and welfare of animals. The vet who owned the surgery outright and sold his customers goodwill to IVC Evidensia Ltd, got such a good price for it. He is now retired in his late forties, while his former clients are steadily being fleeced by this company.

    As for supplementing your income by overcharging for drugs because you think you are not paid enough. Really! You can always find someone who earns more than you. Most would think those wage packets good and there we were thinking you vets did it for the love of the job. Also comparing buying from amazon and the high street. I personally would not touch amazon, but you can’t compare buying your sundries from the high street/amazon to buying lifesaving drugs for an animal at greater expense from a vet to getting a prescription and with that a choice to buy cheaper life saving drugs for that animal. What are you on?

    1. The points raised by the Competition Commission in 2003 were acted on in the early 2000s; and as such the sources you quote are largely obsolete. You may find it enlightening to read the relevant section of the RCVS Code of Conduct which sets out the veterinary surgeon’s professional obligations in terms of the Fair Trading requirements. In fact, the list of the “top 10” was recently withdrawn because of the success of the measure in increasing competition.
      Regarding IVC and other corporate entities, yes, many UK practices are indeed owned by corporates. IVC itself is largely owned by EQT, a capital funds investor. This is a massive change in the industry, and one which many vets are uncomfortable with as well. That still does not address the issue with pricing though – if you look at the actual budgets for a veterinary practice, it is very clear that medicine charges subsidise professional fees. So if you want your medicines at online dispensary prices, accept a £50-70 consult fee (the same as an NHS GP appointment costs the taxpayer). The money has to come from somewhere!
      There are certainly major questions about how veterinary practices should be run, and I absolutely agree. But “greedy vets ripping off the client” is not main issue here.

      1. What has changed in 17 years is the chickens have come home to roost. Vets were found in 2003 to be behaving really. Refusing in some cases to even write prescriptions. Not handing on discounts and rebates. I’m only too happy to pay well for consultation (I’ve never said I wouldn’t) and I think it’s so easy to pass the blame onto the customer like vets do as their default reply, when found to be doing the things vets were found doing in 2003 and pretty much still doing, because you assume we won’t want to pay you well enough for your time. Why don’t vets do some research into how people would feel about paying more for consultation rather than use this as an excuse for subsidising income by massively overpricing products to them and the over pushing of products on customers? It would be nice to get back to a more leisurely feel in veterinary surgeries, rather than the conveyor belt way they are now run, for all of us. Also more continuity (seeing the same vet) of care especially for palliative care would also be nice. Vets rather than sales reps.

        The problem is vets cosied up with pharma and now many are selling out to pharma without a thought for the legacy they are leaving for the next generation. Pharma is going to want to recoup the money they have overpaid for these surgeries and that will be coming out of the customers pocket not the vets. But stay in denial and keep repeating the mantra, “It’s the customers fault because they won’t pay you fairly for your expertise and time.”

        1. The “vets cosying up to pharma” idea is an old one with very little evidence behind it. Certainly I don’t know any vets who got any of the kickbacks that we’re allegedly supposed to have had… And I’m not convinced that pharmaceutical companies actually own the big corporates. The evidence I’ve seen is highly circumstantial and I haven’t been able to verify any of it. If it were true I would expect each corporate to require sale of one particular manufacturer’s product only – but the guidelines for the corporates are largely based on what’s cheapest and change rapidly depending on the market. This is not consistent with the conspiracy theory that they are owned by a pharmaceutical company.
          Regarding consult fees – I have spoken to a lot of my colleagues working in practice over the weekend and the consensus is that most would love to transfer to charging appropriately for our professional time and selling meds at cost, but with the exception of the farm vets (who are doing this), the small animal practices who have tried it report that they get more abuse from clients and see animal owners less willing to seek veterinary attention for their pets.

          1. So you are saying that speaking with other vets and them saying they never do such things or ever have overrides an evidence based investigation that found vets to be doing such things.
            Well, I went directly to the company that has taken over my vets and asked, “Are you owned by pharma?” Head office secretary did not know what they were and I was told I would be rung back with an answer. That’s nearly a week ago and I’m still waiting for an answer.

          2. I said that speaking to vets (as you suggested I do) I was told that the few who had tried increasing prices on professional fees had found that it resulted in more unhappy owners. I said this was anecdotal because unfortunately due to the Competition Commission report that you keep discussing I am not in fact permitted to ask other vets how they arrange their pricing structure except in very vague and general terms.
            This “evidence based” report you keep citing is 17 years old and does not claim that vets are owned by pharmaceutical companies. You have so far produced no evidence that this is so.
            Your vets has not yet told you who their ultimate owners are; this is probably because they are owned by an investment vehicle. Not telling you highly sensitive commercial data might be a PR own goal, but does not prove that they are owned by pharmaceutical companies.

          3. I rang the IVC head office not my vets to answer the question about being owned by pharma, as my vets had already been economical with the truth with me, telling me that it was just a Bristol vets, who own surgeries in that area. I imagine if they had been honest about who was taking them over. They could of suffered some haemorrhaging of customers and is probably why there was no big announcement of their takeover to the customers. Keeping the waters still.
            You said, “Certainly I don’t know any vets who got any of the kickbacks that we’re allegedly supposed to have had” So you have spoken with vets about this investigation and they have denied ever doing any of the things that were found out in that investigation, well at least the “kickbacks” because how could you make such a statement otherwise?
            17 years is not that long ago. It takes a long time to change behaviours especially when they are beneficial. The investigation found a very beneficially relationship between pharma and vets saying, “through interconnections of benefit, in that each of those engaged in the conducts benefits from the conducts of the others through their combined effects.” When I refer to vets becoming owned by pharma, I mean veterinary surgeries not the vets personally.
            It is Private Equity buying up practices under often the cloak of a pharma companies and consolidating pharma and veterinary practice, because pharma is pretty much owned by Private Equity. Interesting read I found https://vetidealist.com/private-equity-veterinarians/
            On abuse about charging more for consultation. You do know that you will never please all the people all the time and I suspect they also get abuse about the percentage they mark up drugs. I imagine if it was done in an informed manner and explained it would lead to you providing cheaper drugs. I suspect most would see reason.
            Funny how I must provide prove and you seem only to need to provide hearsay. It would be nice to see the exact numbers we are talking about of abuse and numbers of vets that have put up consultation fees, dropped drug fees and most importantly before doing so explained this thoroughly to their clients and then got abuse compared to the numbers who excepted it. Then compared to abuse they get for the markup on drugs they do.

            As you have asked me, I would like to see some evidence to the claims of the vets you have spoken with. I already know of people less likely to seek veterinary advice due to big rises in fees before Covid 19. 20% rise in veterinary costs were recorded the previous year to Covid 19. Fees in my surgery for procedures such as vaccinations, neutering and out of hours have risen after Covid 19 from 50% to 30%.

          4. I’m sorry but I am not going to share private conversations with you, especially when they relate to confidential material.
            Private equity is not a big plot – it’s just a funding stream. It makes no difference to the pharmaceutical company how much the customer is charged, just whether they get the price they set (spoiler – they do).
            Fundamentally, the issue here is whether vets should use prescription drug sales to cross-subsidise professional fees, or not. Personally, I think that there are good reasons for doing so. Except for emergencies, you can get medication more cheaply elsewhere with a script. But if professional fees go up, there’s no legal or ethical alternative for the customer to paying the full (massively higher than now) price.
            You might be willing to pay a £70-100 consultation fee, but nothing I have seen suggests that most of the animal owning public are of the same mind, and doing so would be to risk causing massive animal welfare problems as people become even less willing to seek veterinary attention for their animals.
            I don’t think this discussion is going anywhere, to be honest, as it’s clear that we fundamentally disagree on this point. I wish you well, but I do not think that continuing this thread would be productive for anyone.

          5. I have not asked you to share private conversations. I just asked for numbers.
            The investment companies care how much return they get for their investment, so as pharma is owned via shares by the investment companies. They do care about pricing ultimately.
            Yes, it is a funding stream, but you forgot to say, a funding stream that will want it’s funding back and much more. So now clients in many veterinary practices, will not only have to pay the veterinary practices cost, but also line the pockets of the private investors. Clients will be paying the vet, nurse wages, along with over priced drugs and then on top of that we will be paying share holders a return on their investment.
            So maybe we should ask along with is it ethical to subsidise vet’s fees by overpricing drugs, is it also ethical to expect clients to pay the cost of selling out to private investment?
            There is a big ethical question in where we are going with the treatment of pets. I think often they are being over treated (which is welfare issue in itself) and one of the primary reasons why I feel relying on over pricing products to subsidise your consultation fees is wrong, because it inevitable puts pressure on to sell more product than give value to your time with a client.
            The book ‘Are We Pushing Animals to Their Biological Limits?: Welfare and Ethical Implications’ by Temple Grandin and Martin Whiting is an interesting read on the subject.
            I understand that at the end of the day a veterinary surgery is a business and needs to make a profit, but there is a thin line between making a honest profit and profiteering from a business. With private investment in surgeries that line is set to become very thin.
            Personally, I think this thread has been very productive. A really good insight into the mindset of the veterinary mind.

          6. I would reiterate that many vets are also very concerned about the changes in the industry, and I think that’s part of the problem – it’s a wider industry now rather than a (mostly) honourable profession. As professionals on the ground, I think almost all vets are focussed on animal welfare, but how you square that with a business staying afloat is the problem. This is one of the reasons for the corporate takeover: vets in general don’t make – and often don’t want to be – good business managers, because the animal is the focus, not the bottom line. As you rightly say, the risk with having professional business-people involved is that the opposite can become true. The partnership model is far less popular than it was because of debt aversion amongst younger vets (in part as a result of the 2008-9 recession, but largely because of wider social changes I suspect), and that is exaggerated by the huge sums offered by corporates. I don’t think corporates are necessarily a bad thing, but the changes we’re seeing are in some cases dramatic. I honestly don’t know what a better solution here is, except perhaps mutualisation… and that doesn’t have a great history in for example the banking profession.
            Again, thank you – we get so much unthinking vet-bashing that it’s nice to be able to debate the underlying issues!

  18. I think there is little sympathy for vets. All vets are a business, even if they are not for profit. These days it’s even more apparent. Most customers also work for a business. Every business operates according to a business model. You lose here, you gain elsewhere.

    In vets’ cases, you gain elsewhere with other treatment that is impossible online. Where those fees are often by insurance companies, ultimately those costs are covered by premiums, paid for by… yes, us pet owners. Those fees not covered by insurance are paid for by pet owners who would pay anything to look after their pet. I’m not naive, pet owners should realise there are costs associated with looking after any animal. But all we’re trying to do is find the best price. Same as any business.

    My vet charged me £12 for a non-repeatable prescription for flea treatment valid for 3 months. When I questioned why it wasn’t repeatable they said it was because they hadn’t seen the pet for a routine injection. Well, smack my head but why didn’t the vet offer that option so I could’ve killed two birds? Deary me.

    So, I take my cat for a check-up and booster. They advise me that I’d have to pay again for ANOTHER prescription. They couldn’t alter the first one. But, by the way, it was ok to use the new prescription for flea treatment for my other cat – which they hadn’t seen. None of which makes any sense.

    I don’t begrudge paying for a prescription but it does seem incredibly bizarre to pay for a piece of paper that took 5 minutes to find details, print and sign where there has been no inspection of the animal requiring treatment. So, forgive me if it does all sound like exactly what it is: a bit of a scam.

    1. Sounds like a bit of confusion at the practice there! A prescription is only valid for the patient it’s written for. If it says “Mr Fish’s cats” (for example), then it can be used for any of them (and this would be legal), but if it names “Fluffy Fish” (or whatever) then it can only be used for Fluffy.
      I think someone at the practice has got themselves rather mixed up here to be honest!

    2. It’s time we the aggrieved pet owners did some thing rather than moan about the Vets.
      The solution is very simple. Any person can own a Veterinary Surgery in UK.
      Let’s open a chain of veterinary surgeries all over the country. We will hire then best vets, and pay them equivalent to their medical counterparts in the NHS to be fair.
      Sell medicines to clients at wholesale prices and keep the consultation fee affordable let say £20 or less for 20 minutes consultation.
      If we become a large consortium we could even manufacture all our one pet medicine and cut out the Big Pharma.
      We could call ourselves Vets for People with Pets.
      Let’s provide a model veterinary practice for other vets to follow. Let’s teach them how to run a successful Veterinary practice without ripping of the pet loving people of UK.
      Enough said, time for Action.

  19. Just back from a Medivet practive after collecting a 15ml bottle of Loxicom. Firstly, just want to say that I am delighted with the quality of the care received with our Medivet practice. The vets are caring, thoughtful and communicate very well. I wouldn’t take my pets anywhere else. However, £36 for something that would cost me less than £8 elsewhere (350% increase) is unacceptable.

    What we need is transparency. A vet practice is expensive to run and there needs to be a good profit margin. I get that. Any overhead costs and profit margin should be included in the cost of consultation and not hidden away in the cost of meds and appliances. Any other method is misleading.

    1. It’s a really hard issue. I agree on transparency, but there’s a huge problem with people who shop around for the cheapest consult fee; or who refuse to seek veterinary attention for their animals because of the consultation fees. If all the income was on the consult fee, doesn’t that penalise those owners who were responsible but whose animals didn’t need much treatment?

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